Re: Bulging Lumbar disks and biking

[GeorgiaPeach]

Hello TE members,

I was hoping to hear what experience people had with back problems and biking. Recently, my DH did the usual "Y-chromosome" activity of lifting very heavy things he shouldn't (lawnmower, heavy boxes, etc) in an effort to help move his dear mother. This was also in the setting of being pretty deconditioned. He developed acute severe back pain immediately, which was followed by tingling in one leg. When the pain and nerve symptoms persisted, we resorted to getting an MRI and seeing a neurosurgeon. Turns out he has bulging of two lower lumbar disks (no herniation or nerve root impingement, nothing surgical) and likely severe musculoskeletal injuries. This was two months ago and the pain is slightly better but still present and fairly intense. It will definitely take months to heal. I feel really bad for him!

My question to the group is whether they know people who have been able to return to biking after such an injury has healed. The neurosurgeon recommended swimming and possibly biking once the pain improved but I wonder if the stooped-over position of riding a bike will ever agree with him. He is pretty discouraged because he already has orthopedic problems that prevent activities like running and hiking and playing tennis. He was atleast hoping that he could bike. I don't think he'd ever be a serious hard-core biker, but I could see him wanting to mountain bike and road bike on weekends (especially since I am trying to get back into biking).

Any thoughts from the group? I have searched the archives and couldn't find a thread about this particular problem.

Thanks!

Georgia

[OakLeaf]

Here's a discussion from my favorite fitness blog.

[kermit]

I have the same problem. An old fracture to L3 and three bulging discs. The important part is to get treatment. Rest alone will not work. My DO starts with heat, massage, a chiropractic adjustment and shots. Find a non-surgical ortho doctor. I have just recently received shots in my facet joints(around the vertebrae into the affected nerves). Really helps. The key is to gets the nerves relaxed and unswollen to heal. Gook luck. I have found that biking helps me. It keeps the core muscles strong. Lots of stretching before and after. Planks also help.

[ttaylor508]

Good news, there is life on the bike after a back injury. DH has had a chronic back condition (work related) for years. He has a couple of bulging disks that will flare up now and then. He has been through PT, shots, steroids, pain killers, anti inflammatory drugs and was just short of surgery. The key here is to be smart. When he starts to feel that twinge in his back telling him that a flare up is starting, he knows he needs to back off. He will cut back on any activity that may make it worse. If he takes it easy, he seems to come out of the episode quicker. He is still able to cycle (both indoor and out), ski and do other physical activities as long as he is not in a flare up. And +1 on core strengthening! His PT really emphasize the importance of a strong core.

[yellow]

I have one bulger (L3-L4) and one completely blown (herniated) disk (L4-L5).

I went thru PT, have been on diclofenac for months, etc., but the pain wouldn't go away. I don't want surgery and my orthopedic doc has been very helpful with helping me figure out how to live with this thing. He knows my activity level and he has encouraged me to stay as active as I want.

I went from whining about the pain to getting angry about it. Once the swelling was under control from my last trigger (sleeping on a *%@&ing cot), I made three changes that have changed my life. I can't believe how much better my back feels. The changes are:

1. Sitting on one of these at work. No more regular chairs.
2. Every morning I do 100 "good mornings" with just a ski pole (no weight)
3. Crossfit 3-4 times a week...by far the most beneficial thing I'm doing

For me the key was even more core strength. I was already pretty strong, but my front was way stronger than my back because I had been protecting my back for a long time. I can now sleep through the night without pain and I feel way, way better. I will have to keep it all strong for the rest of my life (unless I want to be in pain). I have quite a lot of OA also, but so far that's something I can control.

When you have back pain your initial response is to baby it. That didn't work for me...I had to get aggressive with tackling it. I am finally in control of it; it's no longer in control of me. And it feels GOOD! I am able to do anything I want.

Encourage him to get serious about core strength and staying active. Back pain really sucks. I hope he finds relief soon!

[Tuckervill]

I had the surgery (twice, the second time due to reinjury, both back in the early '90s), and I've never been happier about that decision. I was bed-bound and losing sensation in my right leg, so my blow-out might have been worse than someone else's.

I don't have any back pain anymore. But I do second the idea that you need balanced strength on both sides of you body.

Karen

[GeorgiaPeach]

Thanks everyone for the suggestions. I was just wondering when you all felt like it was safe to start exercising. Do you wait for the pain to be nearly gone or do you begin exercising with the pain. He is two months post-injury and it still feels like "a soldering iron in my back." It is somewhat better than immediately post-injury, but is still rather severe and barely tolerable. His job demands a lot of him too so the last thing he wants is the pain to get worse.

[Trek420]

But I have a compression fracture of one disc and so much wrong with my joints that if I was a horse they'd shoot me (no actual horses were shot to make this post).

See a doctor.
See a PT.

Hopefully find one of each that bike.

Do what they say

Also just a personal tip, find a LBS that has experience with such issues and get a bike fit. Even if his bike is fit for him within fractions of an inch his body is now different.

So once the Dr. and PT check off for him to ride, ride to the LBS

[GeorgiaPeach]

P.S. No worries about whether your advice comes with medical experience or training. We've already gotten that. I just want practical experience from active people on this forum. Sometimes that's more helpful anyway! Thanks again for the tips.

[Wahine]

If your DH is still having that much pain he likely needs better pain management through medication or other medical procedures. If the nerve is inflamed, there are injections that can be done to help that come around much faster. These are usually done by specialists and should be done with a flouroscope (kinda like a live video x-ray) to make sure the injected medication makes it to the target tissue. There are also medications that help with nerve pain much better than the standard Vicodin, Codeine etc. Here, I would refer people to our local pain management clinic, you might have to talk to your family MD or neurosurgeon about this and to get a referral. I'm not saying that all his pain is coming from nerve pain. I'm just trying to give you some examples and reasons why you should be discussing other non-surgical options with the Doc.

PT is very helpful for learning positions to avoid, activities to avoid and starting up with exercises in a nice graded and safe manner.

As for how long and when is it safe to do certain activities... that is very individual and is another really good reason why he should be going to a PT or being monitored regularly by a Doc. There really is no way to answer that question except with the help of a professional that has one on one time with your DH.

The longer he is in a lot of pain and not funcitoning normally, the longer it will take him to recover so I would strongly recommend you look into these things sooner rather than later.

The majority of back injuries will recover and he should be able to return to cycling. But 2 months is too long for him to be putting up with that kind of pain and activity restriction.

[Miranda]

I have had some of my disc come out. And I have multi-level degenerative disc disease (worst ones atm in all regions of my spine: neck, mid back, and lumbar).

Well, I think for a man, it's harder being this way. In terms of society and if they have more physical jobs (prior to getting back issues). Sometimes I tell people I have back problems and need help lifting a 'whatever' in public asking for assistance. Other times I don't even need to get that far in the conversation as chivalry is not dead in the world and some heroic gent will lift my stuff for me to save the day (and save herendous back pain from doing stuff I should not).

You have good advice on PT. And the lbs fitting. It really sux when you are limited and have to change how you do the activities you once loved. But, being in constant pain not being able to do anything really sux more. That is my resolve. I make the most of what I can do--and make my mind up that I am going to be happy about it. Crying in a corner being depressed wasn't working so well for me, thus I took a new approach.

I ride my road bike bar and saddle even. On the hoods, I'm pretty straight spined. I'm bike shopping now, and I have to keep my back in mind. In spin class I ride handle bars further up to give my back a break. I went to PT. Huge help and education. I left my desk job that required me to sit for long periods of time (very bad for disc compression pain). I practice "abdominal bracing" all the time (contracting abs in tight--supports back). My abs are like a rock--helps to support my disc. Strong legs also equal a healthy back--use the legs to lift properly in a squat--not round/bend the disc over.

Errr... mtb, well ya gotta be careful. Even with suspension, it's a lot of jarring. Plus, the crash and twist the spine factor is a bad thing. I ride the easy trail stuff on my hard-trail mtb, and dismount on things that are questionable for my skill level. Peeps think I'm a wuss... well, I would be crying in pain for months with a disc blown out. He could ride with me--I understand.

Don't let him get bummed that he has to give up riding... modification can work wonders for things. It has to start with the mind first.

Good Luck!